In order to determine whether thermography is useful for diagnosing abnormal autonomic nervous function (ANF) in patients with vertigo, we tested 51 patients with this procedure. Hand skin temperatures were measured bilaterally before and after ice water immersion. R-R intervals on ECG (R-R) and pulse wave velocity (PWV) were also measured to examine ANF. Thermography results were correlated with the test results, and a final diagnosis of ANF was determined. In this study, 16 patients (31 %) showed abnormal thermal findings; a useful parameter was found to be the rate of recovery of the average skin temperature. However 14 patients (27 %) with normal thermography findings were finally diagnosed as having abnormal ANF on the basis of the results of R-R and/or PWV measurements. Thus, thermography may be an abjunct diagnostic modality.